PN has been increasingly used to support the nutritional needs of the neonatal patients. It has been common practice to replace IV lines for PN daily out of concern for greater potential for infection in patient receiving PN. The increased use of PN has contributed to higher costs for patient care from pharmacy charges and time required for nursing procedure for line changes. It has been reported that frequency of catheter sepsis was related to the frequency of tubing changes in adult patients during PN. The safety of 72-hour PN line changes has also been demonstrated in the pediatric patients. There is, however, no information regarding this practice in the neonates. The neonatal unit adopted a policy to allow 72- hour line change for all IV fluids(including PN) at the discretion of the neonatologists since March 1994. Typically, 72-hour line change for PN is used when infant's blood chemistry is stable and the nutrient contents in PN fluid is ”maximized“. Intralipid is infused separately and the tubing set is changed with PN fluid. Multivitamin preparation was infused daily over a 6-hour period.

To study the safety and cost-effectiveness of this practice, we reviewed the records of neonates who received PN during 3/94 to 3/96. One hundred thirty-one patients received PN during this period. Records were available on 129 patients. Seventy- two hour line change occurred in 64 patients (Group 1) and daily in 65 patients (Group 2). Positive blood culture was considered PN related if drawn within 5 days after discontinuation of PN. PN related infection is determined by positive blood culture and the presence of clinical symptoms and/or antibiotic treatment. The savings of PN cost was$220/day/patient. We conclude that extending PN line change to 72 hours is safe and cost-effective in the neonatal patient. Table

Table 1 No caption available.
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